Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $128.82 / $173.78	Facility	26	$125.89	$128.82	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $562.34 / $2,290.87	Professional		$338.84	$562.34	$2,290.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $223.87 / $524.81	Professional	26	$104.71	$223.87	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $354.81 / $1,000.00	Professional	TC	$223.87	$354.81	$1,000.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $426.58 / $645.65	Professional		$323.59	$426.58	$645.65
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $151.36 / $169.82	Professional	26	$134.90	$151.36	$169.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $295.12 / $537.03	Professional	TC	$288.40	$295.12	$537.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $562.34 / $1,258.93	Professional		$281.84	$562.34	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $138.04 / $251.19	Professional	26	$85.11	$138.04	$251.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $380.19 / $1,096.48	Professional	TC	$194.98	$380.19	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $380.19 / $724.44	Professional		$331.13	$380.19	$724.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $120.23 / $165.96	Professional	26	$107.15	$120.23	$165.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $263.03 / $549.54	Professional	TC	$223.87	$263.03	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $489.78 / $1,047.13	Professional		$323.59	$489.78	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $120.23 / $199.53	Professional	26	$72.44	$120.23	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $363.08 / $812.83	Professional	TC	$223.87	$363.08	$812.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $389.05 / $524.81	Professional		$338.84	$389.05	$524.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $125.89 / $165.96	Professional	26	$109.65	$125.89	$165.96
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $263.03 / $363.08	Professional	TC	$229.09	$263.03	$363.08